What's the difference between POLST and Advance Directives?

There are a few important differences.

You cannot use a POLST Form to name a surrogate. You can only do that with an Advance Directive.

Emergency medical service (EMS) personnel cannot follow your Advance Directive during an emergency but they can follow a POLST Form. This is because POLST is a medical order. In other words, a POLST Form is a way for your health care professional to tell EMS what treatment to give to you. An Advance Directive is a legal document that does not give orders but tells the health care team at the hospital what you generally want/don’t want.

Your health care professional (doctor, nurse practitioner or physicians assistant) must sign your POLST Form—they should be filling it out for you too! POLST is a medical order and must be signed by a health care professional.

Since a POLST form is a medical order, a copy is kept in your medical record (and the Oregon POLST Registry unless you opt out) so it is easily located during an emergency. It typically hard to find Advance Directives.

Almost everyone should have an advance directive- not everyone should have a POLST. POLST is intended to be used by those individuals who are seriously ill or frail who are nearing the end of their life.

Key Points:

POLST Forms and Advance Directives are not the same thing but both can play a role in your advance care planning- they can work together!

Both are voluntary—you don’t have to have one. But you should know why each is important.

What Is an Advance Directive?

An advance directive is a legal document that allows you to share your wishes with your health care team if you can’t speak for yourself. An Oregon advance directive allows you to:

Identify the person you want the health care team to work with in making decisions about your medical care (known as a “surrogate”); and

Generally say what kinds of medical treatment you would or would not want.